Can imaging modalities be used as follow-up criteria after brucellar sacroiliitis treatment?

• Published in: Journal of infection in developing countries 2017-02, Vol.11 (2), p.123-128
• Main Authors: Bilgeturk, Aybars, Gul, Hanefi Cem, Karakas, Ahmet, Mert, Gurkan, Artuk, Cumhur, Eyigun, Can Polat
• Format: Article
• Language: English
• Subjects: Adult; Anti-Bacterial Agents - administration & dosage; Brucellosis - diagnostic imaging; Brucellosis - drug therapy; Doxycycline - administration & dosage; Drug Monitoring - methods; Female; Follow-Up Studies; Humans; Magnetic resonance imaging; Magnetic Resonance Imaging - methods; Male; Radionuclide Imaging - methods; Retrospective Studies; Rifampin - administration & dosage; Sacroiliitis; Sacroiliitis - diagnostic imaging; Sacroiliitis - drug therapy; Scintigraphy; Streptomycin - administration & dosage; Young Adult
• ISSN: 1972-2680; 2036-6590; 1972-2680
• DOI: 10.3855/jidc.6599

This study aimed to identify a follow-up modality that can be used to evaluate therapeutic responses in patients receiving treatment for brucellar sacroillitis and to determine whether antibiotherapy can be stopped. A total of 32 patients with sacroiliac joint involvement demonstrated via magnetic resonance imaging or bone scintigraphy were followed up and treated. Patients received 200 mg/day of doxycycline and 600-900 mg/day of rifampicin for 3-21 months, and 1 g/day of streptomycin for 21 days. The mean age of the 32 patients involved was 21.81±4.09. In total, 10/32 patients did not complete therapy, and the remaining 22 patients received combination antibiotic treatment for a mean of 8.95±4.34 months. Of the 22 patients, 15 underwent MRI, and 7 of them did not consent to MRI. Similarly, 17 patients were followed up by bone scintigraphy, and 5 patients did not have scintigraphy results. In 9/17 patients followed up with bone scintigraphy, sacroiliitis findings were found to reduce after a mean of 7.44±3.71 months, whereas in 12/15 patients on whom MRI was performed,  there were no active sacroiliitis findings for a mean of 6.95±2.83 months. While active involvement findings in bone scintigraphy were observed for a longer period in scintigraphy images, active sacroiliitis findings disappeared in a relatively shorter period of time with MRI. Therefore, we have demonstrated that high-resolution MRI is a very sensitive technique compared to scintigraphy.